TY - JOUR
KW - behavioral health
KW - Depression
KW - Mental Health
KW - payment reform
KW - value-based payment
AU - N. Z. Counts
AU - G. Wrenn
AU - D. Muhlestein
A1 - 
AB - Value-based payment initiatives, such as the Medicare Shared Savings Program (MSSP), offer the possibility of using financial incentives to drive improvements in mental health and substance use outcomes. In the past 2 years, Accountable Care Organizations (ACOs) participating in the MSSP began to publicly report on one behavioral health outcome-Depression Remission at Twelve Months, which may indicate how value-based payment incentives have impacted mental health and substance use, and if reforms are needed. For ACOs that meaningfully reported performance on the depression remission measure in 2017, the median rate of depression remission at 12 months was 8.33%. A recent meta-analysis found that the average rate of spontaneous depression remission at 12 months absent treatment was approximately 53%. Although a number of factors likely explain these results, the current ACO design does not appear to incentivize improved behavioral health outcomes. Four changes in value-based payment incentive design may help to drive better outcomes: (1) making data collection easier, (2) increasing the salience of incentives, (3) building capacity to implement new interventions, and (4) creating safeguards for inappropriate treatment or reporting.
AD - Mental Health America, 500 Montgomery St, Suite 820, Alexandria, VA, 22314, USA. ncounts@mentalhealthamerica.net.; Morehouse School of Medicine, Atlanta, USA.; Leavitt Partners, Salt Lake City, USA.
BT - Journal of general internal medicine
C5 - Financing & Sustainability; Opioids & Substance Use
CY - United States
DO - 10.1007/s11606-019-05047-x
JF - Journal of general internal medicine
M1 - Journal Article
N2 - Value-based payment initiatives, such as the Medicare Shared Savings Program (MSSP), offer the possibility of using financial incentives to drive improvements in mental health and substance use outcomes. In the past 2 years, Accountable Care Organizations (ACOs) participating in the MSSP began to publicly report on one behavioral health outcome-Depression Remission at Twelve Months, which may indicate how value-based payment incentives have impacted mental health and substance use, and if reforms are needed. For ACOs that meaningfully reported performance on the depression remission measure in 2017, the median rate of depression remission at 12 months was 8.33%. A recent meta-analysis found that the average rate of spontaneous depression remission at 12 months absent treatment was approximately 53%. Although a number of factors likely explain these results, the current ACO design does not appear to incentivize improved behavioral health outcomes. Four changes in value-based payment incentive design may help to drive better outcomes: (1) making data collection easier, (2) increasing the salience of incentives, (3) building capacity to implement new interventions, and (4) creating safeguards for inappropriate treatment or reporting.
PP - United States
PY - 2019
SN - 1525-1497; 0884-8734
T1 - Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
T2 - Journal of general internal medicine
TI - Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
U1 - Financing & Sustainability; Opioids & Substance Use
U2 - 31093839
U3 - 10.1007/s11606-019-05047-x
VO - 1525-1497; 0884-8734
Y1 - 2019
Y2 - May 15
ER -